While meaningful use is ul- timately all about making smarter decisions, Alberto Goldszal says that for ra- diologists, the smartestdecision right now is not to overthink. “If you focus onwhat Stage 1 is about—capturing data—then you’refine,” he says, “Don’t dwell on why you’re doing it,”even if it seems pointless to ask a patient about smok-ing status when he’s in the office to have a broken armX-rayed. Goldszal knows all about capturing data: hehad to capture reams of it as an Alzheimer’s researcherat Johns Hopkins, and later at the National Institutesof Health. Once he figured out how to manage his owndepartment’s data, he started to do the same for otherdepartments. One thing led to another and now he’sthe CIO for one of the largest independent radiologypractices in the country. University Radiology has 85radiologists at nine locations in central New Jersey anddoes more than a million studies a year. The practicewent to replace its radiology information system in2009. When Stage 1 meaningful use rules were final-ized in 2010, its vendor, Medinformatix, Los Angeles,was able to provide a certified system soon after. Morethan 90 percent of the practice’s radiologists have at-tested, for $1.1 million in incentives so far. “That’s freecash flow as far as we’re concerned.”Just Do Itthat was prepared early. Because they sell to dif-ferent specialties, they knew what was coming.Most radiology vendors weren’t concerned aboutmeaningful use. They were reacting after the factand had to retrofit. And a lot of radiologists didn’tpay attention to certification. Some of the big RISvendors didn’t get certified, and if you didn’t havea certified product in 2011, you couldn’t take ad-vantage of the incentive program.

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Only 150 radiologists industrywide attested in
2011, and only 800 attested this year—out of maybe 20,000 who are eligible. A great many radiology
groups are no longer vying for the incentive—they
are just hoping not to get penalized. Vendors are
booked solid for the next year. You can’t just decide
to buy a system and have it done right away.

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We can’t take credit for great vision: We were justin the right place at the right time with a vendor

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It took some time to get people used to answeringa lot of the questions that aren’t in the routine radi-ology workflow. They would want to know why wewere asking about colorectal screening or smokingwhen they were there for an X-ray of the foot.We would say, “The government wants it.”Sometimes they feel their privacy is being invaded,or that the answers will get back to the insurancecompany, but as time passes, their concerns willdiminish because everyone is asking them thesequestions.